Role of Routine Preoperative Upper Gastrointestinal Endoscopy in Symptomatic Cholelithiasis: A Prospective...

To assess the prevalence of concurrent upper gastrointestinal (UGI) conditions through preoperative UGI endoscopy in patients with symptomatic cholelithiasis.

This prospective observational study, conducted at a tertiary care facility, involved 103 patients. All participants underwent preoperative endoscopy. Treatment was divided into three categories based on endoscopic findings: cholecystectomy (Group 1), cholecystectomy with medical treatment (Group 2), and postponed surgery (Group 3). Symptom scores were evaluated before surgery and during the postoperative follow-ups.

The study group had a higher proportion of females (57.3%), with most participants aged 41-50 years (27.2%). Abdominal pain (73.8%) and heartburn (68.9%) were the most common symptoms. UGI endoscopy revealed significant concurrent conditions, including esophagitis (30.1%), hiatus hernia (18.4%), and gastric erosion (18.4%). Based on endoscopic results, 58.3% of patients underwent cholecystectomy, 38.8% received medical treatment alongside surgery, and 2.9% had their surgery delayed. Mean symptom scores significantly decreased in both Group 1 and 2, reaching zero by the sixth week postsurgery.

A high incidence of concurrent UGI pathology was observed in patients with symptomatic gallstone disease and dyspepsia. Preoperative endoscopy altered management in a significant proportion of cases and may improve postoperative symptom resolution. Thus, routine preoperative endoscopy could help reduce persistent postcholecystectomy symptoms.